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目的比较超声乳化白内障摘出术中不同切口矫正术前角膜散光的作用。方法患者58名(75眼)按术前角膜散光程度分为3组,每组患者选择不同手术切口及角膜散光松解切口。A组(25眼)的术前角膜散光≤1.0D,手术切口为角膜屈光力最大径线上的角膜缘内透明角膜隧道切口;B组(25眼)的术前角膜散光>1.0D～2.0D,手术切口同A组,同时在对侧角膜缘内2mm处做一弧长1/4象限,深度60%或80%角膜厚度的弧形板层角膜切口;C组(25眼)的术前角膜散光>2.0D,手术切口同A组,同时在对侧角膜缘内做一长3.2或5.5mm的穿透性角膜隧道切口。术后观察角膜散光的变化情况。结果术后3个月时,各组手术引起的角膜散光变化分别为:(0.34±0.15)D、(0.86±0.22)D和(1.79±0.43)D。结论在屈光力最大径线上的角膜切口可以矫正术前存在的角膜散光,联合对侧透明角膜切口可以增加矫正效果。
Objective To compare the effect of preoperative corneal astigmatism with different incisions in phacoemulsification cataract extraction. Methods Fifty-eight patients (75 eyes) were divided into 3 groups according to the degree of preoperative corneal astigmatism. Each group of patients selected different surgical incisions and corneal astigmatism to release the incision. The corneal astigmatism was less than or equal to 1.0D in group A (25 eyes), the corneal limbal clear corneal incision on the largest diameter of corneal power, the preoperative corneal astigmatism in group B (25 eyes) was 1.0D to 2.0D , The incision was performed in the same way as group A. At the same time, an arc-shaped lamellar corneal incision with a length of 1/4 quadrant and a depth of 60% or 80% of the corneal thickness was made at a distance of 2 mm in the contralateral limbus. In group C (25 eyes) Corneal astigmatism> 2.0D, surgical incision with the same group, at the same time in the contralateral limbus to do a long 3.2 or 5.5mm penetrating corneal tunnel incision. Postoperative observation of changes in corneal astigmatism. Results The changes of corneal astigmatism caused by operation were (0.34 ± 0.15) D, (0.86 ± 0.22) D and (1.79 ± 0.43) D at 3 months after operation. Conclusion Corneal incision on the maximum diameter of refractive power can correct preoperative corneal astigmatism, combined with the contralateral clear corneal incision can increase the correction effect.